Selective laser ablation of venous thrombus: implications for a new approach in the treatment of pulmonary embolus.
Selective laser ablation of venous thrombus: implications for a new approach in the treatment of pulmonary embolus.
复制标题
静脉血栓的选择性激光消融：对治疗肺栓塞新方法的影响。
DOI：
10.1002/lsm.1900080507
复制
发表时间：
1988
影响因子：
2.4
通讯作者：
Prince,MR
中科院分区：
文献类型：
--
作者：
LaMuraglia,GM;Anderson,RR;Parrish,JA;Zhang,DY;Prince,MR
采用激光辐射消融静脉血栓或栓塞，参数不会损伤血管内组织。通过直径为320 μ m的光纤将482 nm、1 μsec脉冲染料激光器的输出输送至新鲜血栓（T）、静脉或肺栓塞（VE）、下腔静脉（IVC）、肺动脉（PA）、肺动脉瓣和内膜（心房和心室）的体外样本。消融T和VE的平均阈值能量密度分别为1.1和5.1 J/cm 2。相反，IVC和PA的平均阈值能量密度显著更高（P< 0.0001），分别为120和124 J/cm 2。在不对肺动脉造成组织学损伤的条件下，血栓消融效率超过100 mg/J。为了将消融研究与组织的光学吸收相关联，研究了新鲜T、VE、IVC和PA的光学特性。与IVC和PA相比，T和VE的血红蛋白物质的482 nm吸收高出10倍以上。这解释了消融阈值的差异，从而解释了所遇到的选择性。这些观察结果比血管系统中的任何其他研究都证明，使用脉冲光辐射，静脉血栓的有效激光消融是可行的，具有广泛的安全范围，并且不会损伤周围的血管组织。
Laser radiation was employed to ablate venous thrombus or emboli with parameters that would not injure endovascular tissues. Output from a 482‐nm, 1‐μsec pulsed dye laser was delivered through a 320‐μmdiameter fiber to in vitro samples of fresh thrombus (T), venous or pulmonary emboli (VE), inferior vena cava (IVC), pulmonary artery (PA), pulmonary valve, and endocardium (atrial and ventricular). The mean threshold fluences for ablation of T and VE were 1.1 and 5.1 J/cm2, respectively. In contrast, the mean threshold fluences for IVC and PA were significantly higher (P< 0.0001), at 120 and 124 J/cm2, respectively. Ablation efficiency of thrombus was in excess of 100 mg/J, under conditions that caused no histologic injury to the pulmonary artery. To correlate ablation studies with optical absorption by the tissues, optical properties of fresh T, VE, IVC, and PA were studied. Hemoglobin species accounted for the more than 10 times higher 482‐nm absorption by T and VE compared to IVC and PA. This explains the differences in ablation thresholds and, thus, the selectivity encountered. These observations demonstrate, more than any other study in the vascular system, that with pulsed optical radiation, efficient laser ablation of venous thrombus is feasible with a wide margin of safety, and without damage to the surrounding vascular tissue.